Health care groups hope for bet­ter in ’19

The Oklahoman (Sunday) - - OPINION -

WHEN fed­eral match­ing funds were re­duced for Ok­la­homa’s Med­i­caid sys­tem in re­cent years, state of­fi­cials han­dled that change by re­duc­ing pay­ments to health care providers.

This year, fed­eral match­ing funds are ex­pected to in­crease. Providers ar­gue rea­son­ably that a por­tion of that money should be used to now in­crease pay­ments to doc­tors, hos­pi­tals and other pro­fes­sion­als.

Med­i­caid, the gov­ern­ment-funded pro­gram that pays for health care for lower-in­come cit­i­zens, in­volves state and fed­eral funds. Un­der a for­mula used by the fed­eral gov­ern­ment, more pros­per­ous states re­ceive a smaller fed­eral match while poorer states have a larger share of Med­i­caid ex­penses cov­ered by the fed­eral gov­ern­ment.

Around the year 2000, roughly 71 cents out of ev­ery Med­i­caid dol­lar spent in Ok­la­homa came from the fed­eral gov­ern­ment. To­day, the fig­ure is around 58 cents on the dol­lar.

The match is ad­justed each year based on a three­year rolling av­er­age of each state’s eco­nomic growth. In Ok­la­homa, that for­mula re­sulted in fed­eral match­ing funds be­ing cut as the state en­tered an oil bust re­ces­sion be­cause the multi-year av­er­age re­flected the oil boom ac­tiv­ity pre­ced­ing the down­turn. So fed­eral Med­i­caid funds were cut at the same time state rev­enue fell. The way Med­i­caid is struc­tured, the pri­mary way states can ad­just spend­ing is to cut pay­ments to doc­tors and other providers, and this is what oc­curred.

Later this year, the fed­eral match is ex­pected to in­crease so roughly 62 cents out of ev­ery Med­i­caid dol­lar spent in Ok­la­homa will come from the fed­eral gov­ern­ment. If state spend­ing on Med­i­caid is sim­ply main­tained at last year’s level, the new fed­eral match­ing rate will trans­late into an in­crease of $37 mil­lion for state nurs­ing homes, $94 mil­lion for hos­pi­tals and $50 mil­lion for en­ti­ties that care for people with de­vel­op­men­tal dis­abil­i­ties.

The ex­tra fed­eral money, providers ar­gue, should be mostly used to raise provider pay­ments to the lev­els seen be­fore the down­turn. If rates aren’t in­creased, they say, many providers may go out of busi­ness. In the past six months, four nurs­ing homes have closed in Ok­la­homa, and more are ex­pected to do the same if rates don’t in­crease. Providers car­ing for the de­vel­op­men­tally dis­abled have an 82 per­cent turnover in di­rect care staff be­cause pay av­er­ages $8.58 per hour — less than work­ing be­hind a fast-food counter — and that low pay is caused in part by low Med­i­caid pay­ments. The me­dian op­er­at­ing mar­gin of ru­ral Ok­la­homa hos­pi­tals is now neg­a­tive-5.9 per­cent.

Some of those sta­tis­tics could be im­proved if Ok­la­homa gov­ern­ment main­tains its cur­rent level of state fund­ing for Med­i­caid and uses the ad­di­tional fed­eral dol­lars to boost provider rates. Yet health care of­fi­cials, who re­cently met with The Oklahoman ed­i­to­rial board, say law­mak­ers may in­stead cut state Med­i­caid fund­ing, think­ing the in­creased fed­eral match will make up for the loss of state dol­lars. That’s not the way to go.

Law­mak­ers this year have passed more than $610 mil­lion in tax in­creases and other rev­enue mea­sures, much of it to ben­e­fit ed­u­ca­tion. As things stand, it ap­pears those gains are be­ing gen­er­ated not only by pass­ing tax in­creases, but by di­vert­ing fund­ing from the treat­ment of some of Ok­la­homa’s need­i­est cit­i­zens.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.